Nomogram for predicting occurrence and prognosis of liver metastasis in colorectal cancer: a population-based study
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ORIGINAL ARTICLE
Nomogram for predicting occurrence and prognosis of liver metastasis in colorectal cancer: a population-based study Mingshuang Tang 1,2 & Hongmei Wang 3 & Yitong Cao 4 & Ziqian Zeng 2 & Xuefeng Shan 3 & Lihua Wang 1 Accepted: 21 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose This study aimed to investigate the prevalence, risk, and prognostic factors for synchronous liver metastasis (LM) in colorectal cancer (CRC) and to construct nomogram for predicting occurrence and prognosis of synchronous LM. Methods A total of 203,998 CRC patients who were registered in the SEER database between 2010 and 2016 were included. Logistic regression was used to analyze risk factors and Kaplan-Meier was used to estimate the overall survival of CRC patients with LM. Potential prognostic factors were identified by multivariable Cox regression. For predicting the risk for development and prognosis in CRC patients with LM, we constructed nomogram and the predictive performance was estimated by the receiver operating characteristics cure, the concordance index, and calibration curve. Results In total, 15.3% of the CRC patients (N = 31,288) had synchronous LM. Male gender, black, uninsured status, left colon, T4/T1, and bone and lung metastases were positively associated with synchronous LM risk. The 1-year, 3-year, and 5-year overall survival rate was 49.1%, 18.4%, and 9.2%, respectively. Older age, male gender, black, uninsured status, poor histological differentiation, lymphatic metastasis, T4/T1, positive carcinoembryonic antigen, and lung, bone, and brain metastases were associated with the overall survival. Nomogram was constructed to predict the development and prognosis of synchronous LM and both of them were proved to have good calibration and discrimination. Conclusion LM is highly prevalent in CRC patients. Nomogram basing on the risk and prognostic factors for synchronous LM was proved to have good performance for predicting the probability of LM occurrence and prognosis. Keywords Colorectal cancer . Liver metastasis . Incidence . Survival . SEER . Nomogram
Introduction Colorectal cancer (CRC) ranks the third lethal and the fourth most commonly diagnosed cancer in the globe [1]. The 5-year survival rate for CRC patients is about 56%, but the survival can be significantly truncated when diagnosed with metastasis
* Lihua Wang [email protected] 1
Emergence Department, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
2
Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
3
Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
4
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
[2–4]. It was reported that approximately 20% of CRC patients were found with metastasis at initial diagnosis [5] and liver i
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